Greenland

Located to the northeast of Canada, Greenland lies mostly within the Arctic Circle, extending to within less than 500 miles (800 km) of the North Pole. It is bordered on the north by the Lincoln Sea and the Arctic Ocean, and on the east and south by the G
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eenland Sea, the Denmark Strait, and the Atlantic Ocean.

Its climate is bleak and Arctic, although rapid changes like bright sunshine and powerful blizzards are common. Average January and July temperatures in the south are 21°F (-6°C) and 45°F (7°C). In the north, average January and July temperatures are -31°F (-35°C) and 39°F (4°C). Average monthly precipitation decreases from 9 inches (24 cm) in the south to about half an inch (1.5 cm) in the north. Although summer rainfall is concentrated in the southwest, snow can fall in any month. Summers can be rather pleasant on the southwest coast, but the inland ice is uniformly cold, with a July average of 10°F (-12°C) and a February mean of -53°F (-47°C).

Health Precautions========================General CautionsRecent medical and dental exams should ensure that the traveler is in good health. Carry appropriate health and accident insurance documents and copies of any important medical records. Bring an adequate supply of all prescription and other medications as well as any necessary personal hygiene items, including a spare pair of eyeglasses or contact lenses if necessary.

Denmark, Greenland and the Faeroe Islands US Consular Information SheetAugust 15, 2006 COUNTRY DESCRIPTION: Denmark is a highly developed stable democracy with a modern economy. Greenland is a self-governing dependency of Denmark. The Faroe Islands are a self-governing overseas administrative division of Denmark. Read the Department of State Background Notes on Denmark for additional information.

ENTRY REQUIREMENTS: Passport and visa regulations are similar for Denmark, Greenland, and the Faroes. A valid passport is required. U.S. citizen tourist and business travelers do not need visas for visits of up to 90 days. That period begins when entering any of the following countries which are parties to the Schengen agreement: Austria, Belgium, Denmark, Finland, France, Germany, Greece, Iceland, Italy, Luxembourg, The Netherlands, Norway, Portugal, Spain, and Sweden. See our Foreign Entry Requirements brochure for more information on Denmark and other countries. Contact the Royal Danish Embassy at 3200 Whitehaven Street, N.W. Washington, DC 20008, telephone (202) 234-4300 or visit its website at for the most current visa information.

Note: Although European Union regulations require that non-EU visitors obtain a stamp in their passports upon initial entry to a Schengen country, many borders are not staffed with officers carrying out this function. If an American citizen wishes to ensure that his or her entry is properly documented, it may be necessary to request a stamp at an official point of entry. Under local law, travelers without a stamp in their passports may be questioned and asked to document the length of their stay in Schengen countries at the time of departure or at any other point during their visit, and could face possible fines or other repercussions if unable to do so.

Find more information about Entry and Exit Requirements pertaining to dual nationality and the prevention of international child abduction . SAFETY AND SECURITY: Denmark remains largely free of terrorist incidents, however the country shares, with the rest of Western Europe, an increased threat of Islamic terrorism. Like other countries in the Schengen area, Denmark's open borders with its Western European neighbors allow the possibility of terrorist groups entering and exiting the country with anonymity. Americans are reminded to remain vigilant with regard to their personal security and to exercise caution.

Public demonstrations occasionally occur in Copenhagen and other Danish cities and are generally peaceful events. Prior police approval is required for public demonstrations, and police oversight is routinely provided to ensure adequate security for participants and passers-by. Nonetheless, as with any large crowd comprised of diverse groups, situations may develop which could pose a threat to public safety. U.S. citizens are advised to avoid areas where public demonstrations are taking place. For the latest security information, Americans traveling abroad should regularly monitor the Department of State's web site , where the current Worldwide Caution Public Announcement , Travel Warnings, and Public Announcements can be found.

Up-to-date information on safety and security can also be obtained by calling 1-888-407-4747 toll-free in the United States, or, for callers outside the United States and Canada, a regular toll line at 1-202-501-4444. These numbers are available from 8:00 a.m. to 8:00 p.m. Eastern Time, Monday through Friday (except U.S. federal holidays).

The Department of State urges American citizens to take responsibility for their own personal security while traveling overseas. For general information about appropriate measures travelers can take to protect themselves in an overseas environment, see the Department of State's pamphlet A Safe Trip Abroad . CRIME: Denmark, Greenland, and the Faroes all have very low violent crime rates, however, non-violent crimes of opportunity have slightly increased over the last few years, especially in Copenhagen and other major Danish cities, where tourists can become targets for pickpockets and sophisticated thieves. Criminals frequent airports, train stations, and cruise ship quays to take advantage of weary, luggage-burdened travelers. Thieves also operate at popular tourist attractions, shopping streets, and restaurants. In hotel lobbies and breakfast areas, thieves take advantage of even a brief lapse in attention to snatch jackets, purses, and backpacks. Women's purses placed either on the backs of chairs or on the floor are typical targets for thieves. Car and home break-ins are also on the rise.

INFORMATION FOR VICTIMS OF CRIME: The loss or theft abroad of a U.S. passport should be reported immediately to the local police and the nearest U.S. Embassy or Consulate. If you are the victim of a crime while overseas, in addition to reporting to local police, please contact the nearest U.S. Embassy or Consulate for assistance. The Embassy/Consulate staff can, for example, assist you to find appropriate medical care, to contact family members or friends, and explain how funds could be transferred. Although the investigation and prosecution of the crime is solely the responsibility of local authorities, consular officers can help you to understand the local criminal justice process and to find an attorney if needed.

Denmark has a program to provide financial compensation to victims who suffer serious criminal injuries. According to existing regulations, the victim must report the incident to the police within 24 hours. Danish police routinely inform victims of serious crime of their rights to seek compensation. The relevant forms can be obtained from the police or the Danish Victims' Compensation Board: Civilstyrelsen, Erstatningsnaevnet, Gyldenløvesgade 11, 1600 Copenhagen V, TEL: (45) 33-92- 3334; FAX: (45) 39-20-45-05; www.erstatningsnaevnet.dk ; Email: erstatningsnaevnet@erstatningsnaevnet.dk . Claim processing time is a minimum of 4 weeks. There is no maximum award limit.

See our information for Victims of Crime .MEDICAL FACILITIES AND HEALTH INFORMATION: Excellent medical facilities are widely available in Denmark. In Greenland and the Faroe Islands, medical facilities are limited and evacuation is required for serious illness or injury. Although emergency medical treatment is free of charge, the patient is charged for follow-up care.

Information on vaccinations and other health precautions, such as safe food and water precautions and insect bite protection, may be obtained from the Centers for Disease Control and Prevention's (CDC) hotline for international travelers at 1-877-FYI-TRIP (1-877-394-8747) or via the CDC's website at . For information about outbreaks of infectious diseases abroad consult the World Health Organization's (WHO) web site at http://www.who.int.en. Further health information for travelers is available at .

MEDICAL INSURANCE: The Department strongly urges Americans to consult with their medical insurance company prior to traveling abroad to confirm whether their policy applies overseas and whether it will cover emergency expenses such as a medical evacuation. Please see our information on medical insurance overseas .

TRAFFIC SAFETY AND ROAD CONDITIONS: While in a foreign country, U.S. citizens may encounter road conditions that differ significantly from those in the United States. The information below concerning Denmark is provided for general reference only, and may not be totally accurate in a particular location or circumstance.

A valid U.S. driver's license may be used while visiting Denmark, but the driver must be at least 18 years old. Driving in Denmark is on the right side of the road. Road signs use standard international symbols. Many urban streets have traffic lanes reserved for public transport only. Unless otherwise noted on traffic signs, the speed limit is 50 km/h in urban areas, 80 km/h on open roads, and 130 km/h on expressways.

Use of seat belts is mandatory for drivers and all passengers. Children under three years of age must be secured with approved safety equipment appropriate to the child's age, size, and weight. Children from three to six years of age may use approved child or booster seats instead of seat belts.

Driving under the influence of alcohol or drugs is considered a very serious offense. The rules are stringently enforced, and violations can result in stiff fines and possible jail sentences.

Copenhagen, the capital and largest city in Denmark, has an extensive and efficient public transportation system. Trains and buses connect Copenhagen with other major cities in Denmark and to Norway, Sweden, and Germany. Bicycles are also a common mode of transportation in Denmark. Passengers exiting public or tourist buses, as well as tourists driving rental cars, should watch for bicycles on their designated paths, which are usually located between the pedestrian sidewalks and the traffic lanes.

Danish expressways, highways, and secondary roads are of high quality and connect all areas of the country. It is possible to drive from the northern tip of Denmark to the German border in the south in just four hours. Greenland has no established road system, and domestic travel is performed by foot, boat, or by air. The majority of the Faroe Islands are connected by bridges or serviced by boat. Although the largest islands have roads, most domestic travel is done on foot, horseback, boat, or by air.

The emergency telephone number for police/fire/ambulance in Denmark and the Faroe Islands is 112. In Greenland contact the local police.

Please refer to our Road Safety page for more information. Visit the website of the country's national tourist office and national authority responsible for road safety at . See also additional information on driving in Denmark at .

AVIATION SAFETY OVERSIGHT: The U.S. Federal Aviation Administration (FAA) has assessed the government of Denmark's Civil Aviation Authority as being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for the oversight of Denmark's air carrier operations. This rating applies to Greenland and the Faroe Islands as well. For more information, travelers may visit the FAA's Internet website at www.faa.gov/safety/programs_initiatives/oversight/iasa .

SPECIAL CIRCUMSTANCES: The official unit of currency in Denmark is the Danish krone. ATM machines are widely available throughout Denmark. Please see our information on customs regulations .

For information concerning the importation of pets into Denmark, please visit the following website:.

CRIMINAL PENALTIES: While in a foreign country, a U.S. citizen is subject to that country's laws and regulations, which sometimes differ significantly from those in the United States and may not afford the protection available to the individual under U.S. law. Penalties for breaking the law can be more severe than in the United States for similar offenses. Persons violating Denmark's laws, even unknowingly, may be expelled, arrested, or imprisoned. Penalties for possession, use, or trafficking in illegal drugs in Denmark are severe and convicted offenders can expect long jail sentences and heavy fines. Engaging in sexual conduct with children or using or disseminating child pornography in a foreign country is a crime, prosecutable in the United States. Please see our information on Criminal Penalties .

CHILDREN'S ISSUES: For information on international adoption of children and international parental child abduction, see the Office of Children's Issues website.

REGISTRATION/EMBASSY LOCATION: Americans living or traveling in Denmark are encouraged to register with the nearest U.S. Embassy or Consulate through the State Department's travel registration website , and to obtain updated information on travel and security within Denmark. Americans without Internet access may register directly with the nearest U.S. Embassy or Consulate. By registering, American citizens make it easier for the Embassy or Consulate to contact them in case of emergency. The U.S. Embassy is located at Dag Hammarskjolds Alle 24; 2100 Copenhagen, telephone: (45) 33-41-71-00; Embassy fax: (45) 35-43-02-23; Consular Section fax: (45) 35-38-96-16; After-hours emergency telephone: (45) 35-55-92-70. Information is also available via the U.S. Embassy's website at http://www.usembassy.dk. The United States has no consular presence in Greenland or the Faroe Islands.* * *This replaces the Consular Information Sheet dated February 10, 2006, to update the section on Entry Requirements and Traffic Safety and Road Conditions.

Kulusuk, Denmark, Oct 17, 2019 (AFP) - Kayaking past blue-white icebergs drifting along near a pristine harbour, wandering around colourful houses or trekking in the snow-capped wilderness: July and August are high season for tourists in eastern Greenland. Many of the 85,000 tourists who visit each year head to the west coast, but eastern Greenland, with its glaciers, wilderness and wildlife starring whales and polar bears, is also drawing visitors.

Sarah Bovet, a 29-year-old Swiss artist, said it's hard to know what to expect. "Thinking you're going to be surprised, you are even more so in reality," she said standing outside a hostel in the tiny village of Kulusuk. Bovet was on an artistic residency in Greenland when she visited Kulusuk and its 250 souls. Although she had imagined a small village before arriving, its stunning views and bright colours still came as a surprise. With just one supermarket, an airport built in the 1950s by the US military to serve a Cold War radar base, and a harbour surrounded by brightly painted wooden houses, most of the villagers appreciate the extra revenue from tourism.

Justus Atuaq, a young hunter in Kulusuk, takes tourists out on sled tours in March and April -- the spring high season -- earning money that helps him feed and care for the dogs he uses for racing and hunting. "Now I can take dogsleds for hunting, and sometimes tourists coming from other countries also want to dogsled," he said outside his wooden house. Tourists also take boat trips during the summer high season from July to August. Arrivals to the island grew 10 percent year-on-year from 2014 to 2017, and three percent in 2018, according to the tourist board, Visit Greenland. Many adventure seekers and nature lovers arrive by plane, but cruise ships also bring admirers, hugging the picture perfect coastline.

- Growing strategic importance -But they are not alone in taking an interest in the world's largest island. The Danish territory's rich natural resources and growing strategic importance as the Arctic ice sheet melts have attracted the attention of US President Donald Trump. The Arctic region has untapped reserves of oil, gas and minerals, as well as abundant stocks of fish and shrimp. In August, Trump offered to buy Greenland, then called off a visit to Copenhagen over its refusal to sell.

Denmark colonised Greenland in the 1700s, granting it autonomy in 1979. Today, many Greenlandic political parties advocate full independence. The territory still receives an annual subsidy from Copenhagen, which was 4.3 billion Danish kroner (576 million euros) in 2017, and tourism could help it to become economically self-reliant. Like many parts of Greenland, Kulusuk has no tarmac roads and visitors must travel by plane or boat. The growth in tourism could put a strain on the village's infrastructure, and the sector faces unique challenges given Greenland's location, weather and the cost of travelling there.

Day tours of Kulusuk with flights from the Icelandic capital Reykjavik are 97,000 Icelandic kronur ($780, 700 euros). Jakob Ipsen, a 48-year-old who grew up between Denmark and Greenland's west coast, runs Kulusuk's sole hotel. The 32-room hotel stands beside a fjord, and from its dining room, guests can watch icebergs drift by during the summer. But the region's isolation can be problematic, Ipsen admits. "We have to get all our supplies in with the first ship for the whole summer season, and for the winter season when everything is frozen over, we have to get all our supplies in with the last ship for the whole winter," he said.

- 'They go back as different people' -Greenland must tackle its infrastructure challenges if it wants to develop tourism, Visit Greenland says. Government-funded work is under way to extend runways at the capital Nuuk and Ilulissat, both on the west coast, and a new airport is planned in the south. The tourist body said it would weigh the environmental impact of boosting infrastructure, both on the environment and on local communities. Ipsen worries about the effects of uncontrolled tourism to the region. "We want to try to maintain it as it is, so it's not exploding," he said.

Already, said Johanna Bjork Sveinbjornsdottir, who runs tours in Kulusuk for an Iceland-based company, the rise in visitor numbers is making itself felt. "In the campsites here out in nature where you used to be alone, there's two, three groups at a time," she said. Like Ipsen, she is also concerned about the effect that rising visitor numbers could have on the wilderness around the village. "If you want nature to survive that, you have to build up the infrastructure," she said, pointing to the lack of officially designated campsites around Kulusuk, with no rubbish bins or toilets for travellers outdoors and no one supervising the sites. Despite the concerns, Sveinbjornsdottir hopes visitors will keep coming. "They go back as different people," she said. "Everything is beyond what you ever imagined."

Authorities in Greenland seek tourists and investors with new airports
Tourism Greenland
- 2 years ago

Date: Fri, 16 Nov 2018 14:19:01 +0100

Copenhagen, Nov 16, 2018 (AFP) - Greenland's parliament has adopted a plan to upgrade or build airports to serve the massive North Atlantic island, keen to attract more tourists to its pristine Arctic wilderness. Two airports -- in the capital Nuuk and in the tourism centre Ilulissat -- will be substantially upgraded, making it possible to fly directly to Greenland from Europe and North America.

A new national airport will be built in Qaqortoq in the south. Greenland is an autonomous Danish territory. The plans have been controversial because of Copenhagen's direct financial involvement. The project is estimated to cost at least 3.6 billion kroner (482 millions euros, $546 million). Almost 20 percent of the financing will be provided by Denmark, which contributes 3.6 billion kroner to the island's annual budget. Parliament adopted the proposal late Thursday with 18 out of 29 votes.

In September, the project plunged Greenland into a three-week political crisis, with an independent supporting party quitting the government coalition in protest against Denmark's involvement. The social democratic Siumut party, which has dominated Greenland politics for four decades, was ultimately able to cling to power with a new, narrower majority. "We are creating lots of opportunities for Greenland's future. We are not selling out," Prime Minister Kim Kielsen insisted in parliament's debate, local television KNR reported. The three airports will serve the main population centres of the island, which is home to 55,000 people spread out across an area more than four times the size of France.

Smaller communities have meanwhile complained they will remain isolated. In addition, "other risks have also been raised, like the reaffirmed presence of the US military, which not everyone sees as a positive thing, and the environmental risks brought on by better international connections," Mikaa Mered, a professor of Arctic geopolitics at the ILERI School of International Relations in Paris, told AFP.

Since 2009, Greenland has been largely independent when it comes to its economic policy but foreign and defense issues remain under Copenhagen's control. "The big winner in this affair is Copenhagen. Both on the political, economic and geopolitical levels, Copenhagen is strengthening its positions across the board, vis-a-vis China and the triangular alliance with Washington," Mered said, referring to Beijig's eagerness to invest in the Arctic which has raised concern in the US. Construction of the airports is scheduled to be completed by 2023.

Stockholm, July 13, 2018 (AFP) - A massive iceberg drifting near the coast of Greenland has triggered fears of flooding if it breaks up, leading the authorities to evacuate a high-risk zone. The authorities have urged residents of the Innarsuit island settlement with houses on a promontory to move away from the shore over fears that the iceberg, which was spotted on Thursday, could swamp the area. "We fear the iceberg could calve and send a flood towards the village," Lina Davidsen, a security chief at the Greenland police, told Danish news agency Ritzau on Friday.

The settlement in northwestern Greenland has 169 inhabitants, but only those living closest to the iceberg have been evacuated, Ritzau reported. "The iceberg is still near the village and the police are now discussing what do to next," Kunuk Frediksen, a police chief in the Danish autonomous territory, told AFP. The incident comes weeks after scientists at New York University shot and released a video of a massive iceberg breaking free from a glacier in eastern Greenland in June. Last year, four people died and 11 were injured after an earthquake sparked a tsunami off another island settlement called Nuugaatsiaq, sending several houses crashing into the sea.

Stockholm, Aug 14, 2017 (AFP) - Police in Greenland warned people to stay away from western areas of the island as wildfires scorched swathes of scrubland. In a statement, the police said it "still discourages all traffic -- including hiking and hunting -- in two areas around Nassuttooq and Amitsorsuaq." "The fires are not expected to end within the next few days," the statement added. Some of the blazes have been burning since July 31.

Denmark's meteorological service BMI said the island registered its hottest-ever temperature of 24.8 degrees (77 Fahrenheit) on August 10. Last year was Greenland's hottest on record. The Danish territory has lost about 4,000 gigatons of ice since 1995, British researchers said in June, making ice melt on the huge island the biggest single contributor to rising sea levels.

Stockholm, June 18, 2017 (AFP) - Four people were listed as missing Sunday after an earthquake sparked a tsunami off Greenland and forced some residents to be evacuated. "Four people are missing," local broadcaster KNR quoted local police chief Bjorn Tegner Bay as telling a news conference in the autonomous Danish territory. There were no confirmed fatalities, but Bay said 11 houses had been swept away after a magnitude 4 overnight quake off Uummannaq, a small island well above the Arctic Circle. "The huge waves risk breaking over Upernavik and its environs. The residents of Nuugaatsiaq are going to be evacuated," police said on Facebook, referring to nearby hamlets.

Some residents posted images to social media showing huge waves breaking over buildings in the town. "A good explanation is that the quake created a fault at the origin of a tsunami," meteorologist Trine Dahl Jensen told Danish news agency Ritzau, warning of potential aftershocks. "It's not normal, such a large quake in Greenland," she said. KNR quoted Ole Dorph, mayor of Qaasuisup, a municipality in the area affected, as lamenting "a serious and tragic natural catastrophe which has affected the whole region." Danish Prime Minister Lars Lokke Rasmussen tweeted news of what he termed a "terrible natural catastrophe at Nuugaatsiaq." The world's largest island situated between the North Atlantic and Arctic oceans, Greenland, population 55,000, has an ice sheet particularly vulnerable to climate change.

Christmas Island

Date: Tue, 19 Sep 2006 17:41:31 +0200 (METDST) SYDNEY, Sept 19, 2006 (AFP) - A large earthquake with an estimated magnitude of 6.1 struck Tuesday near the Australian territory of Christmas Island, the US Geological Survey said. The quake struck at 20:58 local time (1358 GMT) and its epicentre was located 191 kilometres (119 miles) east-northeast of Christmas Island, the USGS report said. The reading was based on the open-ended Moment Magnitude scale, now used by US seismologists, which measures the area of the fault that ruptured and the total energy released.

27 Aug 2001 A NORWEGIAN ship carrying 438 sick and starving refugees was moored in limbo off Christmas Island last night, with John Howard refusing to allow them to disembark and Indonesia reluctant to let them berth anywhere in its territory. http://email.ni.com.au/Click?q=96-pjPWQtdfI9qzkLcbUQgkSoeR

Timor-Leste

General Information:

The People’s Republic of China is the world’s third largest nation in land mass and shares borders with 16 other countries. It is the worlds most populated country. Nowadays many Irish travellers will b
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going to China for business or holiday trips. Much of the country is mountainous or semidesert and the country lies almost entirely in the temperate zone. Only portions of the southern-most area - the provinces of Yunnan and Guangdong, and the Zhuang autonomous region of Guangxi - lie within the tropics. The monsoon climate is a major influence in the south, but the north and west have a typical continental climate.

Weather Profile:

During the summer, warm moist maritime air masses bring heavy rains to eastern China, and hot humid summer weather is typical. Winter offers a sharp contrast when Siberian air masses dominate. In late winter and spring strong north winds sweep across north China and hazy days caused by dust storms are common. Beijing’s spring is mostly dry. In July and August the weather turns hot and humid. Autumn is the nicest time of the year with many warm, clear days and little wind usually. Chest Complaints Because of the prevailing dust, increased transportation and the burning of soft coal during the winter, Beijing and other major cities in China have a high rate of pollution. This may exacerbate bronchial and/or sinus complaints. The dust level in Lhasa is also very high and this may lead to respiratory problems.

Safety & Security:

The risk of crime against tourists is low but care of personal belonging should be observed at all times. Maintenance of buildings and general safety precautions may not always be in place and so checking for fire exits (and that they are unblocked) is wise. Use the hotel safety boxes and carry photocopies of any important documents rather than the originals where possible.

Local Medications:

Western brand-name drugs or non-prescription medicines are seldom available locally although some Chinese equivalents are to be found at reasonable prices. Always carry your own medication (well marked) on your person and bring enough for your trip.

Rabies:

Rabies is a serious problem throughout China. Reports indicate that as many as five million people are bitten each year by rabid dogs and that approximately 5,000 of these patients die. Travellers should stay well clear of any warm blooded animals, especially dogs. Any contact (lick, bite or scratch) should be treated seriously and immediately by washing out the wound, applying an antiseptic and then seeking urgent medical attention.

River Boat Travel:

Many of the older river boats in China use untreated river water for washing dishes and in the bathrooms. This increases the risk of illnesses such as traveller’s diarrhoea and a parasitic disease called schistosomiasis (Bilharzia). Also be careful that the ferry is not overcrowded and be aware of any sharp corners or rusty edges due to lack of maintenance.

Altitude Sickness in Tibet:

Virtually all of the Tibetan Autonomous region, much of Quinghai and Xinjiang, parts of Sichuan, Yannan and Gansu are above 13,000 feet in altitude. Some main roads in Tibet, Qinghai and Xinjiand go above 17,000 feet. At these levels the available oxygen is very low and altitude sickness may occur. Travellers may experience severe headaches, nausea, dizziness, shortness of breath or a dry cough. These symptoms usually settle over a few days with rest, but if not travellers should seek medical assistance and, if possible, descend to a lower altitude. Travellers with a history of cardiac problems or respiratory difficulties should avoid such high altitudes where possible.

Insect Bites and Malaria:

During the summer months, carry a supply of insect repellent ointments for your trip and use sensible, light coloured clothing to cover yourself when there are mosquitoes or sandflies about. The risk of malaria in most of China is limited but prophylactic tablets may be prescribed depending on your actual itinerary. Other serious mosquito borne diseases do occur so these will need to be considered.

Sunlight:

The sunlight during the summer months and in Tibet at high elevations can be intense so travellers should bring sun screen and sun-glasses and a sensible wide-brimmed hat.

Acupuncture:

Many tourists are tempted to experience this oriental art in its homeland while visiting China. It is essential to ensure that sterile needles are used at all times as otherwise there may be a risk of transmission of a blood borne disease such as the HIV virus or Hepatitis B.

AIDS risk in China:

Official figures suggest that AIDS is a very limited risk in China. Only 707 cases were reported up to October 2000. These very low figures are very difficult to verify and so all travellers should take care not to place themselves at risk where possible.

Customs Regulations:

Never carry any medication for another individual unless they are part of your family. The Chinese authorities have strict drug regulations which may be enforced.

Vaccination Requirements:

There are no vaccination requirements for entry / exit purposes but travellers on short trips should consider the following ... * Poliomyelitis (childhood booster) * Typhoid (food & water disease) * Tetanus (childhood booster) * Hepatitis A (food & water disease) Those planning to spend a longer time in China should consider additional vaccination against conditions like Rabies, Hepatitis B, Japanese B Encephalitis, Meningococcal Meningitis, Diphtheria and Mantoux Test / BCG vaccination.

Summary:

China is teeming with people and a culture very different to ours. It is a land of many contrasts. Travellers generally stay healthy if they follow standard commonsense healthcare advice.

Dili, East Timor, March 5, 2015 (AFP) - An American tourist has returned to the United States after six months trapped in East Timor over the discovery of drugs in a taxi that she was sharing. Stacey Addison arrived back in Portland, Oregon, on Wednesday, embracing her mother tightly during an emotional reunion at the city's airport, TV reports showed. "It's a great feeling, it's a relief to finally be back home, be out of there," she told a local station, adding her experience in East Timor, a tiny half-island nation bordering Indonesia, had been an "emotional rollercoaster". A Facebook group set up to advocate for her release carried a celebratory message on Tuesday announcing that she had left East Timor: "IT'S FINALLY HAPPENED! STACEY IS ON HER WAY HOME!!!!" Addision was arrested on September 5 after methamphetamine was found in the shared taxi that was en route to the capital Dili, but denied any wrongdoing.

The veterinarian, who had just crossed from Indonesia when she was arrested, wrote on Facebook that another passenger -- who was a stranger -- picked up a package containing the drugs, and police later detained everyone in the car. She was initially released from jail after several days but was later re-arrested, although no charges were laid against her. Addison was released again in December, but East Timor authorities hung on to her passport while they continued to investigate her case. Her lawyer had warned that the probe could take two years but last week the East Timor government announced that prosecutors had decided not to pursue her case and "Ms. Addison is now free to leave". The State Department had supported Addison and pressed for her release. East Timor, a poor half-island nation that was occupied by Indonesia for over two decades, imposes tough punishments for drugs cases, including the death penalty for traffickers.

JAKARTA, Feb 03, 2014 (AFP) - A strong 6.1-magnitude earthquake hit eastern Indonesia Tuesday but there was no tsunami alert, seismologists said. The quake struck at 7:36 am local time (2236 GMT Monday), 318 kilometres (197 miles) east-northeast of the East Timor capital Dili in the Banda Sea at a depth of 18 kilometres, the US Geological Survey said.

The Pacific Tsunami Warning Center did not issue any alerts following the tremor in the remote region at the eastern end of the Indonesian archipelago between East Timor and the Maluku islands. In an initial assessment, the USGS said there was a low likelihood of damage or casualties.

Indonesia sits on the Pacific "Ring of Fire", where tectonic plates collide, causing frequent seismic and volcanic activity. A 6.1-magnitude quake struck Indonesia's main island of Java in January, damaging dozens of buildings. Another 6.1 quake that hit Aceh province on Sumatra island in July 2013 killed at least 35 people and left thousands homeless.

AMBON, Indonesia, Dec 01, 2013 (AFP) - A 6.3-magnitude quake hit off eastern Indonesia and East Timor Sunday, seismologists said, but there was no tsunami alert or reports of damage or casualties. The quake struck at 10:24 am local time (0124 GMT), 351 kilometres (217 miles) east-northeast of the East Timor capital Dili at a relatively shallow depth of 10 km, the US Geological Survey said.

The Pacific Tsunami Warning Center did not issue any alerts following the tremor in the remote region at the eastern end of the Indonesian archipelago between the islands of Timor and New Guinea. In an initial assessment, the USGS said there was a low likelihood of damage or casualties. Indonesian officials said they had not received any reports of casualties or damage so far. "From data, the epicentre is quite a distance from the nearest cities and the intensity of shaking is not destructive," Suharjono, the technical head of Indonesia's geophysics and meteorology agency, told AFP.

An AFP correspondent in Dili said no tremor was felt. Johanes Huwae, a police official in the Maluku provincial capital Ambon, one of the cities closest to the epicentre, said "there was no shaking, everything's safe", while the national disaster management agency reported "slight shaking for three to five seconds" in Southwest Maluku. Indonesia sits on the Pacific "Ring of Fire", where tectonic plates collide, causing frequent seismic and volcanic activity. A 6.1-magnitude quake that struck Aceh province on Sumatra island in July killed at least 35 people and left thousands homeless.

Re: Meng Ling Moi's post from Japan re: DENV-3 in 3 Japanese travelers returning from East Timor in March [see ProMED-mail archives 20120319.1074013 and 20120306.1060914]

I am the Australian Embassy's doctor in Dili, East Timor. Our clinic sees expatriates and some locals.

It is likely that I saw one or more of the travellers concerned prior to their return to Japan.

Our small one-doctor clinic saw 45 test-confirmed cases of dengue in February [2012] alone, mostly expatriates. These are not included in the 161 test confirmed cases for East Timor quoted in the previous post. Serotyping is not available in Dili, however reports from my colleagues at the ASPEN military medical facility, where blood samples have been sent to Australia for analysis, have also shown DEN-3 to be the circulating serotype.-------------------------------------------------

Dr Helen Hanson

Australian Embassy Clinic

Dili, East Timor

helenjhanson@gmail.com=========================[ProMED-mail thanks Dr Helen Hanson for this 1st hand report. These types of reports from health professionals in the field who are dealing with outbreaks are especially valuable sources of reliable, current information. Her report confirms the circulation of dengue virus 3 in East Timor.

- East Timor (national). 2 Mar 2012. As of 24 Feb [2012], the Ministry of Health had received 563 reports of dengue (161 confirmed by laboratory tests) in every district except one, including 192 reports of DHF that causes severe abdominal pain, vomiting, and in worst cases, death. This is a 36 per cent increase over reports for the 1st 2 months of 2011. As of 1 Mar [2012], 10 people had died from dengue, according to the government.

Panama

Panama - US Consular Information SheetJune 05, 2008 COUNTRY DESCRIPTION: Panama has a developing economy. Outside the Panama City area, which has many first-class hotels and restaurants, tourist facilities vary in quality. The U.S. dollar is t
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e paper currency of Panama, and is also referred to as the Panama balboa. Panama mints its own coinage. Read the Department of State Background Note on Panama for additional information.

ENTRY/EXIT REQUIREMENTS: U.S. citizens traveling by air to and from Panama must present a valid passport when entering or re-entering the United States. Sea travelers must have a valid U.S. passport (or other original proof of U.S. citizenship, such as a certified U.S. birth certificate with a government-issued photo ID). American citizens can visit travel.state.gov or call 1-877-4USA-PPT (1-877-487-2778) for information on applying for a passport.

Panamanian law requires that travelers must either purchase a tourist card from the airline serving Panama or obtain a visa from a Panamanian embassy or consulate before traveling to Panama. Further information may be obtained from the Embassy of Panama, 2862 McGill Terrace NW, Washington, DC 20009, tel. (202) 483-1407, or the Panamanian consulates in Atlanta, Boston, Chicago, Honolulu, Houston, Los Angeles, Miami, New Orleans, New York, Philadelphia, San Juan, San Diego, San Francisco or Tampa.

U.S. citizens transiting the Panama Canal as passengers do not need to obtain visas, report to customs, or pay any fees. U.S. citizens piloting private craft through the canal should contact the Panama Canal Authority at 011-507-272-1111 or consult the canal’s web page at http://www.pancanal.com.

In an effort to prevent international child abduction, many governments have initiated procedures at entry/exit points. These often include requiring documentary evidence of relationship and permission for the child's travel from the parent(s) or legal guardian not present. Having such documentation on hand, even if not required, may facilitate entry/departure.

Panamanian law requires all persons to carry official identification documents at all times. This law applies to both Panamanian citizens and visitors to the country. Due to an increase in illegal aliens in Panama, the police have been checking documents more frequently, resulting in the detention of people not carrying identification. For this reason, all Americans are encouraged to carry their passports or other official identification at all times.

Information about dual nationality or the prevention of international child abduction can be found on our web site. For further information about customs regulations, please read our Customs Information sheet.

Visit the Embassy of Panama web site at http://www.embassyofpanama.org/cms/index4.phpfor the most current visa information.

SAFETY AND SECURITY: U.S. citizens are warned not to travel to Darien Province. Embassy personnel are only allowed to travel to Darien Province on official business with prior approval of the Embassy’s Regional Security Officer. This restricted area encompasses the Darien National Park as well as privately owned nature reserves and tourist resorts. While no incidents have occurred at these resorts, U.S. citizens, other foreign nationals and Panamanian citizens have been the victims of violent crime, kidnapping and murder in this general area. Reliable communications and medical infrastructure are not readily available in the region, which makes travel therein potentially hazardous. Moreover, all around the Panama-Colombia border area the presence of Colombian terrorist groups, drug traffickers and other criminals is common, increasing the danger to travelers. Note: The Secretary of State has designated the Revolutionary Armed Forces of Colombia (FARC), the National Liberation Army (ELN) and the United Self-Defense Forces of Colombia (AUC) as Foreign Terrorist Organizations.

There is increasing evidence that the Revolutionary Armed Forced of Colombia (FARC), a designated foreign terrorist organization, has increased its operations in Panama’s Darien Province, including in areas far removed from the immediate vicinity of Panamanian-Colombian border. In February 2008 encounters between six FARC members and the Panamanian police near the city of Jaque resulted in the arrest of the FARC members.

From time to time, there may be demonstrations protesting internal Panamanian issues, or manifestations of anti-American sentiment by small but vociferous groups. While most demonstrations relate to labor disputes or other local issues and are typically non-violent, it is nonetheless a good security practice to avoid demonstrations. U.S. citizens are advised to exercise caution on the campus of the University of Panama, where members of radical, anti-U.S. student groups are active. For updated security information, contact the U.S. Embassy Consular Section at the address below.

Visitors should be cautious when swimming or wading at the beach. Some beaches, especially those on the Pacific Ocean, have dangerous currents that cause drowning deaths every year. These beaches are seldom posted with warning signs.

On the Pacific coast, boaters should be wary of vessels that may be transporting narcotics northward from Colombia. Special permission is needed from the Ministry of Government and Justice and the National Environment Authority to visit the National Park on Coiba Island. At this time, the island, a former penal colony, has fewer than 20 prisoners. Boaters should avoid the southeastern coast of Kuna Yala Comarca (San Blas Islands), south of Punta Carreto, on the Atlantic Coast.

Local maritime search and rescue capabilities are limited and well below U.S. standards. For the latest security information, Americans traveling abroad should regularly monitor the Department of State, Bureau of Consular Affairs’ web site at http://travel.state.gov, where the current Travel Warnings and Travel Alerts, as well as the Worldwide Caution, can be found.

Up-to-date information on safety and security can also be obtained by calling 1-888-407-4747 toll free in the U.S. and Canada, or for callers outside the U.S. and Canada, a regular toll-line at 1-202-501-4444. These numbers are available from 8:00 a.m. to 8:00 p.m. Eastern Time, Monday through Friday (except U.S. federal holidays).

The Department of State urges American citizens to take responsibility for their own personal security while traveling overseas. For general information about appropriate measures travelers can take to protect themselves in an overseas environment, see the Department of State’s pamphlet A Safe Trip Abroad.

CRIME: Crime in Panama City is moderate but increasing, particularly because of the activities of youth gangs. The city of Colon is a high crime area. Police checkpoints have become commonplace on weekends on roads in both cities. Based upon reported incidents by local police, the high-crime areas around Panama City are San Miguelito, Rio Abajo, El Chorrillo, Ancon, Curundu, Veracruz Beach, Panama Viejo, and the Madden Dam overlook. Crimes there are typical of those that plague metropolitan areas and range from rapes to armed robberies, muggings, purse-snatchings, "express kidnappings" from ATM banking facilities, in which the victim is briefly kidnapped and robbed after withdrawing cash from an ATM, and petty theft. Tourists recently experienced a problem with armed bandits during an organized canoe trip on the Chagres River. There have been several targeted kidnappings, including in Panama City, one of which involved a U.S. citizen, and one which involved the complicity of corrupt law enforcement officials. If concerned for their safety when being stopped by Panamanian law enforcement, U.S. citizens should consider slowing down and turning on their hazard lights, acknowledging the request to stop, and proceeding deliberately to a safe public place at which to stop.

Panama City has a curfew for persons under 18 years of age. Under the law, students attending night classes must have a carnet or permit, issued by the school or, if employed, a Certificate of Employment. Minors who are picked up for a curfew violation are subject to detention at a police station until parents or legal guardians can arrange for them to be released into their custody. Parents or legal guardians may be fined up to U.S. $50.00 for the violation. INFORMATION FOR VICTIMS OF CRIME: The loss or theft abroad of a U.S. passport should be reported immediately to the local police and the nearest U.S. Embassy or Consulate. If you are the victim of a crime while overseas, in addition to reporting to local police, please contact the nearest U.S. Embassy or Consulate for assistance. The Embassy/Consulate staff can, for example, assist you to find appropriate medical care, contact family members or friends and explain how funds could be transferred. Although the investigation and prosecution of the crime is solely the responsibility of local authorities, consular officers can help you to understand the local criminal justice process and to find an attorney if needed. The Panamanian Government also sponsors a program for Assistance to Victims of Crimes. The program is managed by the Oficina de Asistencia a Víctimas de Crímenes, located at the Policia Tecnica Judicial in the Ancon area of Panama City, telephone number is 011-507-262-1973 or 011-507-512-2222.See our information on Victims of Crime.

MEDICAL FACILITIES AND HEALTH INFORMATION: Although Panama City has some very good hospitals and clinics, medical facilities outside of the capital are limited. When making a decision regarding health insurance, Americans should consider that many foreign doctors and hospitals require payment in cash prior to providing service and that a medical evacuation to the U.S. may cost well in excess of $50,000. Uninsured travelers who require medical care overseas often face extreme difficulties, whereas travelers who have purchased overseas medical insurance have, when a medical emergency occurs, found it to be life-saving. Some insurance policies also include coverage for psychiatric treatment and for disposition of remains in the event of death. In Panama, most hospitals accept credit cards for hospital charges, but not for doctors' fees.

Information on vaccinations and other health precautions, such as safe food and water precautions and insect bite protection, may be obtained from the Centers for Disease Control and Prevention’s hotline for international travelers at 1-877-FYI-TRIP (1-877-394-8747) or via the CDC’s web site at http://wwwn.cdc.gov/travel/default.aspx. For information about outbreaks of infectious diseases abroad consult the World Health Organization’s (WHO) web site at http://www.who.int/en. Further health information for travelers is available at http://www.who.int/ith/en.

MEDICAL INSURANCE: The Department of State strongly urges Americans to consult with their medical insurance company prior to traveling abroad to confirm whether their policy applies overseas and whether it will cover emergency expenses such as a medical evacuation. Please see our information on medical insurance overseas.

TRAFFIC SAFETY AND ROAD CONDITIONS: While in a foreign country, U.S. citizens may encounter road conditions that differ significantly from those in the United States. The information below concerning Panama is provided for general reference only, and may not be totally accurate in a particular location or circumstance.

Panama's roads, traffic and transportation systems are generally safe, but traffic lights often do not exist, even at busy intersections. Driving is often hazardous and demanding due to dense traffic, undisciplined driving habits, poorly maintained streets, and a lack of effective signs and traffic signals. On roads where poor lighting and driving conditions prevail, night driving is difficult and should be approached with caution. Night driving is particularly hazardous on the old Panama City – Colon highway.

Buses and taxis are not always maintained in a safe operating condition due to lack of regulatory enforcement. Auto insurance is not mandatory and many drivers are uninsured. If an accident occurs, the law requires that the vehicles remain in place until a police officer responds to investigate. Traffic in Panama moves on the right, as in the U.S., and Panamanian law requires that drivers and passengers wear seat belts.

Flooding during the April to December rainy season occasionally makes city streets impassible and washes out some roads in the interior of the country. In addition, rural areas are often poorly maintained and lack illumination at night. Such roads are generally less traveled and the availability of emergency roadside assistance is very limited. Road travel is more dangerous during the rainy season and in the interior from Carnival through Good Friday. Carnival starts the Saturday prior to Ash Wednesday and goes on for four days.

Traveling on the Pan American Highway: There is often construction at night on Panama's main Pan American highway. There are few signs alerting drivers to such construction and the highway is not well lit at night. When traveling on the highway, travelers should be aware of possible roadblocks. The Pan American Highway ends at Yaviza in the Darien Province of Panama and does not go through to Colombia. The paved portion of the road ends at Santa Fe, with all-weather surface through Canglón. Travelers going to South America by car may wish to ship their cars on a freighter.

Please refer to our Road Safety page for more information. Visit the web site of the country’s national tourist office at http://www.ipat.gob.pa/ and the national authority responsible for road safety at http://www.mop.gob.pa/default0.asp.

AVIATION SAFETY OVERSIGHT: The U.S. Federal Aviation Administration (FAA) has assessed the Government of Panama’s Civil Aviation Authority as being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for oversight ofPanama’s air carrier operations. For more information, travelers may visit the FAA’s web site at http://www.faa.gov/safety/programs_initiatives/oversight/iasa.

SPECIAL CIRCUMSTANCES: Panamanian customs authorities may enforce strict regulations concerning temporary importation into or export from Panama of items such as firearms and ammunition, cultural property, endangered wildlife species, narcotics, biological material, and food products. It is advisable to contact the Embassy of Panama in Washington or one of Panama's consulates in the United States for specific information regarding customs requirements. In many countries around the world, counterfeit and pirated goods are widely available. Transactions involving such products are illegal and bringing them back to the United States may result in forfeitures and/or fines. Please see our Customs Information.

CRIMINAL PENALTIES: While in a foreign country, a U.S. citizen is subject to that country's laws and regulations, which sometimes differ significantly from those in the United States and may not afford the protections available to the individual under U.S. law. Penalties for breaking the law can be more severe than in the United States for similar offenses. Persons violating Panamanian laws, even unknowingly, may be expelled, arrested or imprisoned. Penalties for possession, use, or trafficking in illegal drugs in Panama are severe, and convicted offenders can expect long jail sentences and heavy fines. Engaging in sexual conduct with children or using or disseminating child pornography in a foreign country is a crime, prosecutable in the United States. Please see our information on Criminal Penalties.

CHILDREN'S ISSUES: For information see our Office of Children’s Issues web pages on intercountry adoption and international parental child abduction.

REGISTRATION / EMBASSY LOCATION:Americans living or traveling in Panama are encouraged to register with the nearest U.S. Embassy or Consulate through the State Department’s travel registration web site so that they can obtain updated information on travel and security within Panama. Americans withoutInternet access may register directly with the nearest U.S. Embassy or Consulate. By registering, American citizens make it easier for the Embassy or Consulate to contact them in case of emergency. The U.S. Embassy and U.S. Consular Section are located in Avenida Demetrio Basilio Lakas, Building No.783 in the Clayton section of Panama City. The international mailing address is: Apartado 0816-02561, Zona 5, Panama, Republic of Panama.

The U.S. mailing address is U.S. Embassy Panama, Department of State, Washington, DC 20521-9100. The telephone numbers for the Embassy are 011-507-207-7000, or for after-hours emergencies, 011-507-207-7200; Consular Section 011-507-207-7030 and fax 011-507-207-7278 or 011-507-207-7303. The Embassy web site is http://panama.usembassy.gov/. E-mail inquiries may be addressed to Panama-ACS@state.gov.* * *This replaces the Country Specific Information for Panama dated December 2007, to update sections on Security and Information for Victims of Crimes.

Panama City, March 31, 2020 (AFP) - The government of Panama on Monday announced strict quarantine measures that separate citizens by gender in an effort to slow the spread of the novel coronavirus. From Wednesday, men and women will only be able to leave their homes for two hours at a time, and on different days. Until now, quarantine regulations were not based on gender.

Men will be able to go to the supermarket or the pharmacy on Tuesdays, Thursdays and Saturdays, and women will be allowed out on Mondays, Wednesdays and Fridays. No one will be allowed to go out on Sundays.

The new measures will last for 15 days. "This absolute quarantine is for nothing more than to save your life," security minister Juan Pino said at a press conference. According to Pino, more than 2,000 people were detained last week for not abiding by the quarantine. Since the first case was reported on March 10, Panama has confirmed 1,075 cases of the coronavirus, 43 of which are in intensive care, and 27 deaths.

Panama City, March 11, 2020 (AFP) - Panama's health minister on Tuesday confirmed eight cases of the new coronavirus in the country, including one death, the first virus-linked death in Central America. "Of the eight patients we are reporting, one person is in intensive care, another unfortunately died," Minister Rosario Turner said during a press conference in Panama City. According to the ministry, a 64-year-old man who was already suffering from diabetes complications associated with bacterial pneumonia died of the COVID-19 virus on Sunday. Turner said that the deceased man was the director of a school and that two of the other cases were affiliated with the same establishment. The other seven people who tested positive ranged in age from 29 to 59 and all but one had recently travelled abroad.

Panama is the second Central American country to record cases of the COVID-19 virus following Costa Rica, where 13 people tested positive, including three Americans. The Panamanian government ordered public and private schools closed until April 7 in the potentially affected regions. The Health Ministry, meanwhile, called on the population "to remain calm and follow prevention protocols." A total of 117,339 cases of the novel coronavirus have been recorded worldwide, including 4,251 deaths, across 107 countries and territories, according to an AFP tally.

The Ministry of Health (MINSA) reported this [Tue 25 Jun 2019] 5 cases of equine encephalitis in Darien province. The Minister of Health Designate, Rosario Turner, explained that they are dealing with children.

Meanwhile, the current Minister of this office, Miguel Mayo, signalled that now it is being determined if they are dealing with Venezuelan equine encephalitis or eastern equine encephalitis, since both have circulated in Panama.

Mayo added that currently the patients are being treated in the Hospital del Nino Jose Renan Esquivel and that the ministry will provide more details of these cases in the coming hours.

The disease, transmitted by the bite of infected _Culex_ mosquitoes, attacks the nervous system causing disorientation, reduction in reflexes and movement of arms and legs. The usual hosts are horses and humans. [Byline: Urania Cecilia Molina]

========================

[This is not the 1st time there have been human cases of encephalitis caused by both Venezuelan equine encephalitis (VEE) and eastern equine encephalitis (EEE) in Darien province of Panama. As noted earlier, both viruses occur in Panama. The case fatality rate for humans infected with VEEV is relatively low -- less than 1 percent, whereas it is much higher in individuals with neurological disease from EEEV infections. Children are more severely affected by VEEV infection than adults.

If VEE virus infection in these children is confirmed, it would be of interest to know which VEEV subtype is involved in these cases, as subtype IAB or IC can cause massive equine epizootics over wide geographic areas with spillover to many humans. Subtype ID usually causes a few sporadic human cases (see ProMED-mail archive no. http://promedmail.org/post/20100617.2034). The results of confirmation of the virus involved in these cases is awaited with interest. - ProMED Mod.TY]

Panama City, May 13, 2019 (AFP) - A 6.1-magnitude earthquake hit Panama on Sunday, injuring at least five people and causing damage to businesses and homes, officials said. The strong quake struck at a depth of 37 kilometers (23 miles) in the far west of the country near the Costa Rican border, according to the US Geological Survey.

It was followed by a smaller 5.4-magnitude quake in Colon province, on central Panama's Caribbean coast, according to the country's National Civil Protection System (Sinaproc). Five people were injured in the first quake, which hit 22 km from the town of Puerto Armuelles, said Sinaproc. Four homes were damaged, including two that collapsed, it said.

President Juan Carlos Varela had said on Twitter earlier that just one person was hurt, in Puerto Armuelles. He reported damage to homes and businesses in the Central American nation. School classes were suspended for Monday in Baru district, where the first quake struck. There was no tsunami alert issued from the Pacific Tsunami Warning Center.

The second quake occurred late Sunday and was not related to the afternoon quake near Puerto Armuelles, Sinaproc said. So far no damage has been reported from the second quake, it added. In November 2017 a 6.5-magnitude quake on the Pacific coast of Costa Rica left buildings swaying in the capital San Jose and contributed to the deaths of two people who had heart attacks. Further north, two months earlier in September 2017 a 7.1-magnitude earthquake killed more than 300 people in Mexico.

The Panama Ministry of Health has reported an increase in cases of hantavirus infection in Los Santos Province, Republic of Panama, to the Pan American Health Organization/World Health Organization (PAHO/WHO). Between 1 Jan - 22 Dec 2018, a total of 103 confirmed cases of hantavirus [infections] have been reported at the national level, 99 of which were reported in Los Santos Province. In Los Santos Province, 51 cases were classified as hantavirus fever (HF) without pulmonary syndrome, and 48 cases were classified as hantavirus pulmonary syndrome (HPS), including 4 deaths.

Of the 51 HF cases, 41 percent were female, 55 percent aged between 20-59 years, with 76 percent occurring between June 2018 and November 2018.

Of the 48 HPS cases, 56 percent were female, 67 percent aged between 20-59 years, with more than half of the cases occurring in February 2018 (17 percent) and between June 2018 and September 2018 (42 percent).

Cases were confirmed by serology and polymerase chain reaction (PCR). Sequencing determined that the type of virus associated with this outbreak is Choclo virus. It was 1st isolated in 1999 in the western Republic of Panama.

Hantavirus cases have been reported in the Republic of Panama since 1999 (Figure 1). In the last 5 years, transmission has been documented in Los Santos, Herrera, Veraguas, and Cocle provinces. During 2018, cases have been reported in Los Santos (99 cases, Figure 2), Herrera (2 cases), Cocle (one case) and Veraguas (one case) provinces (Figure 3). Since the reservoir for hantavirus is sylvatic rodents and transmission can occur when people come in contact with rodent habitats, the current increase in hantavirus cases in the Republic of Panama could be related to changes in the abundance and distribution of rodent species, as well as strengthened surveillance and laboratory capacity at the provincial level. Environmental and ecological factors affecting rodent populations can have a seasonal impact on disease trends.

Figure 1 [graph]. Distribution of HF and HPS cases by year, Republic of Panama, 1999-2018 (as of November 2018).

HPS is a zoonotic, viral respiratory disease. The causative agent belongs to the genus _Hantavirus_, family Bunyaviridae. Infections are acquired primarily through inhalation of aerosols or contact with the excreta, droppings or saliva of infected rodents. Cases of human hantavirus infection usually occur in rural areas (forests, fields, farms, etc.), where rodents hosting the virus might be found. Infected individuals may experience headache, dizziness, chills, fever and myalgia. They may also experience gastrointestinal (GI) symptoms including nausea, vomiting, abdominal pains, and diarrhoea, followed by sudden onset of respiratory distress and hypotension. Symptoms of HPS typically occur from 2-4 weeks after initial exposure, though symptoms may appear as early as one week to as late as 8 weeks following exposure. The case fatality rate can reach 50 percent.

In the Americas, HPS cases have been reported in several countries. In January 2019, World Youth Day will be hosted in the Republic of Panama. This mass gathering will take place predominantly in Panama City, while side events will occur in other provinces. Though a seasonal increase of hantavirus during the month of January has not been previously documented, increases in cases have been related to outdoor and agricultural activities in rural environments. Nevertheless, participants to the World Youth Day should be provided with recommendations and guidance on how to take appropriate precautionary measures to reduce their risk of infection. Health awareness campaigns for health personnel and the general public are planned for the coming weeks. Organisers and public health authorities should collaborate with travel and tourism sectors in placing educational materials and appropriate signage at strategic locations and points of entry (e.g. airports, public transport stations, travel agent offices). Alternative forms of media including public service announcements on planes, ships and public radio should also be considered.

Based on current epidemiological data and public health response, WHO's risk assessment is that there is no significant risk of international spread of HPS in relation to this event.

WHO advice

PAHO/WHO recommends that Member States continue efforts of detection, investigation, reporting, and case management for the prevention and control of infections caused by hantavirus.

Particular attention should be paid to travellers returning from the affected areas, who are advised to report their travel history, as early identification and timely medical care can improve clinical outcomes.

Care during the initial stages of the illness should include antipyretics and analgesics as needed. In some situations, patients should receive broad-spectrum antibiotics while confirming the etiologic agent. Given the rapid progression of HPS, clinical management should focus on the patient's haemodynamic monitoring, fluid management, and ventilation support. Severe cases should be immediately transferred to intensive care units (ICUs).

Health awareness campaigns should aim to increase detection and timely treatment of the illness and prevent its occurrence by reducing people's contact with rodents. Preventive measures should cover occupational and eco-tourism related hazards. While most usual tourism activities pose little or no risk of exposing travellers to rodents or their excreta, people who engage in outdoor activities such as camping or hiking should take precautions to reduce possible exposure to potentially infectious materials.

HPS surveillance should be part of a comprehensive national surveillance system and must include clinical, laboratory and environmental components. WHO recommends the implementation of integrated environmental management, with the goal of reducing rodent populations. Throughout the World Youth Day event, syndromic surveillance may alert public authorities to increased influenza-like and GI symptoms among mass gathering participants.

At this time, WHO does not recommend any restrictions on travel and/or trade to the Republic of Panama based on available information for the current hantavirus outbreak.

For the last 5 World Youth Day events (2016 in Krakow, Poland; 2013 in Rio de Janeiro, Brazil; 2011 in Madrid, Spain; 2008 in Sydney, Australia; and 2005 in Cologne, Germany), the range in the number of attendees was 500 000 in Australia (<https://bit.ly/2rXptP1>) to 3,700,000 in Brazil (<https://bit.ly/2EVxs77>).

====================

[Although ProMED-mail has reported most of the cases of hantavirus infections in Panama during 2018, this WHO summary and the graphs and map may be of interest to subscribers and other readers. It is helpful to note that laboratory diagnosis has been carried out by the Gorgas Memorial Laboratory, the national reference laboratory in Panama. The methods used for diagnosis are mentioned in this report. Interestingly, Choclo is the hantavirus identified in these cases, based on genomic sequence analysis. Curiously, Choclo virus is never mentioned in the popular press reports that come to ProMED-mail from Panama. It is reassuring to know that the virus responsible for these cases, or at least the ones for which samples and diagnostic testing was done, confirm the ProMED conclusion that Chocolo virus was involved. Earlier, Dr. Jan Clement suggested that Seoul hantavirus might be involved in some of the cases in the Americas including Panama. Presumably, genomic analysis by the Gorgas Lab would have detected this virus. Nonetheless, diagnostic laboratories should be aware of this possibility and look for it.

The WHO report indicates that rodents are the reservoir hosts of Choclo virus but does not specify which rodents play that role. The rodent host of Choclo virus is the pygmy rice rat (_Oligoryzomys fulvescens_), a photograph of which can be accessed at <http://www.medwave.cl/medios/perspectivas/Hantavirus/Actualiz/Fig2.jpg>. These rodents live in and around agricultural areas and adjacent houses and buildings. They can be persistently infected with the virus and shed it in urine, feces, and saliva, the source of human infections.

World Travel News Headlines

Nicosia, June 6, 2020 (AFP) - Cyprus opens back up for international tourism on Tuesday, with airports welcoming visitors after an almost three-month shutdown, and a bold plan to cover health care costs for visitors. But with arrivals expected to be down by 70 percent this year due to the chaos brought by the COVID-19 pandemic, it's a leap of faith for the small Mediterranean holiday island. "Nobody here is expecting to make any money this year", Deputy Tourism Minister Savvas Perdios told AFP. "We are setting the stage for the beginning of our recovery in 2021."

The divided island's tourism sector normally accounts for around 15 percent of GDP but has dried up in past months amid global measures to combat the spread of the novel coronavirus. Cyprus saw a record 3.97 million arrivals in 2019, with more than half its market made up of British and Russian visitors. But even if the island's airports in Larnaca and Paphos will open up to arrivals on Tuesday with the first flight due to arrive from Athens around midday (0900GMT), neither Britain or Russia are among the 19 countries allowed to land there.

The list of permitted countries, which also include Bulgaria, Germany and Malta, have been chosen based on epidemiological data and split into two categories. Initially all travellers will need to show proof of a negative COVID-19 test undertaken within 72 hours of travel, but from June 20, only those arriving from six countries in the second category, such as Poland and Romania, will need to do so. The government says the lists will be revised weekly and more countries can be added.

Cyprus will also cover accommodation, dining and medical care for any tourists who fall ill with the COVID-19 illness during their stay, as well as accommodation and meals for their families and close contacts. "What we offer and what we sell is not the sun and the sea, it's hospitality, and this is an extension of our hospitality," Perdios said. The government has designated a 100-bed COVID-19 hospital for tourists that Perdios said would be located in the Larnaca region, while 112 ICU units have been allocated for visitors. Perdios said several four-star hotels would provide 500 quarantine rooms for close contacts of those who fall ill.

- 'Right thing to do' -A raft of other health measures, including disinfection protocols and temperature checks at border controls, aim to protect travellers and locals alike. "We've gone to big lengths to think ahead of things that could go wrong and try to devise plan Bs and Cs", Perdios said. The Republic of Cyprus, in the south of the island, has registered 960 novel coronavirus cases and 17 deaths. Perdios expressed hope that British tourists could be welcomed "sometime after mid-July", with Russia "slightly later, maybe by a couple of weeks".

A recently announced deal with Hungarian low-cost carrier Wizz Air to open a base in Cyprus from July was also an important step towards expanding and diversifying the island's tourist markets, he said. While no date has been set to allow international tourists to visit the breakaway Turkish Republic of Northern Cyprus, only recognised by Ankara, the health care commitment would still apply to those visiting the north during their stay once the crossings are reopened. "I am very confident that not only will we be able to continue providing our citizens with protection, but also caring for everybody who comes to the island on holiday", he said. "If we are coming out with a scheme like this, it's because we can afford it, but most importantly, because we feel that it's the right thing to do."

Orlando, June 5, 2020 (AFP) - Tourists donned masks Friday and visited the attractions at Universal Orlando, the first of the major theme parks in Florida to open since the COVID-19 pandemic shut them down almost three months ago. Universal Orlando resort and the other theme parks in this central Florida city closed on March 15 to prevent the spread of coronavirus. New back-to-fun rules at the park include temperature controls at the entrance, mandatory use of face masks, markers on the ground to help enforce social distancing and posters thanking the public for their help "during this unprecedented time."

Universal Orlando is only reopening at 35 percent capacity and has launched a system of virtual lines in which space can be reserved, to avoid queues and crowds. Terrence Wilson, 19, was happy with the result. "There's not a lot of people. I can get on all the rides without having to wait 40 minutes or an hour" he told the Orlando Sentinel.

On Monday, the Legoland Florida park opened in the city of Winter Haven, while SeaWorld in Orlando is scheduled to open on June 10. The largest of Orlando's parks, Walt Disney World, will open on July 11. That day the park's Magic Kingdom and Animal Kingdom sections will begin operating, while EPCOT and Hollywood Studios will follow suit on July 15. Orlando is home to most of the state's theme parks and every year welcomes millions of tourists from all over the world.

Riyadh, June 5, 2020 (AFP) - Saudi Arabia on Friday announced a renewed lockdown in the city of Jeddah, gateway to the annual Muslim pilgrimage to Mecca, to counter a new spike in coronavirus cases. "After reviewing the epidemiological situation and the high occupancy rates of intensive care departments, it was decided to take strict health precautions in the city of Jeddah for two weeks," starting from Saturday, the health ministry said. The measures include a curfew running from 3 pm to 6 am, a suspension of prayers in mosques and a stay-at-home order for public and private sector workers in the Red Sea city whose airport serves Mecca pilgrims.

After an easing of precautions in the kingdom in late May, the ministry said that strict measures could also soon return to Riyadh, which was "witnessing a continuous increase during the last days" of critical cases of the pandemic. Saudi Arabia has declared almost 96,000 coronavirus infections and 642 deaths from the Covid-19 respiratory disease, the heaviest toll in the Gulf. It has suspended the year-round "umrah" pilgrimage to Mecca and Medina over fears of the coronavirus pandemic spreading to Islam's holiest cities.

Authorities are yet to announce whether they will proceed with this year's hajj, scheduled for the end of July, but have urged Muslims to temporarily defer preparations for the annual pilgrimage. Last year, some 2.5 million faithful travelled to Saudi Arabia from across the world to take part in the hajj, which all Muslims must perform at least once in their lives if able.

Dublin, June 5, 2020 (AFP) - Ireland will dramatically accelerate its plan to ease coronavirus lockdown restrictions in the coming days, Prime Minister Leo Varadkar said Friday. "Today I can confirm that it is safe to move to phase two of the plan to reopen our country starting on Monday," Varadkar told a press conference. "I'm also announcing an acceleration of the roadmap." More workplaces will open and household visits will be permitted from Monday in line with the government plan to reopen the Republic announced in May.

However an escalation of the scheme will see citizens allowed to travel across their county of residence and/or up to 20 kilometres (12 miles) from home. All shops will also be permitted to reopen whilst the final stage of the "roadmap" to end lockdown -- in place since 28 March -- will be brought forward from August to July. Playgrounds will reopen while the government now intends to allow hotels, restaurants and bars serving food to resume trade on June 29. "We are making progress, we are heading in the right direction, and we have earned the right to be hopeful about the future again," Varadkar said. Ireland has suffered 1,664 deaths from the coronavirus, according to official figures. Recorded deaths peaked at 77 in a single day in April, but by Thursday that figure had fallen to just five.

The Republic last Monday registered its first day without any COVID-19 deaths in more than two months, one week after entering the first phase of its plan to leave lockdown. "We've proved we can suppress the virus, but now we do face another test," said health minister Simon Harris. "We must prove we can live alongside it and keep it weak at the same time."

The easing includes provisions for shops to hold staggered opening hours and social distancing measures to remain in place. "We must remain careful, cautious vigilant, and together," Harris added. Finance minister Paschal Donohoe announced Friday that a government wage subsidy scheme enacted when the nation entered lockdown will be extended until the end of August. To date, 1.37 billion ($1.55 billion) euros has been paid to half a million employees. But he warned "this support cannot last forever" and he expected to see a continued decline in reliance on the scheme.

Quito, June 5, 2020 (AFP) - As much of Ecuador went into lockdown against the coronavirus, scientists shipped out of the Galapagos, leaving important research activity frozen and the Pacific archipelago's tourism in deep crisis. Authorities are desperately hoping for a revival of the vital tourism industry -- the main engine of the local economy -- once visitors are allowed to fly in again from July 1.

In the meantime, local officials say they have to take a leaf out of English naturalist Charles Darwin's book and "adapt to survive." Darwin based his theory of evolution on his studies of the islands' unique flora and fauna. But dozens of researchers following in his footsteps had to leave before air links were shut down as the pandemic advanced. "Science has to a large extent been paralyzed these days in the Galapagos," Diego Quiroga of Quito's San Francisco University told AFP.

Sixteen researchers of various nationalities from the university's Galapagos Science Center were repatriated along with 50 US students when Ecuador shut its borders, suspended flights and imposed strict restrictions on movement in mid-March. The move meant that the Galapagos was largely spared the devastating impact of the virus felt on the mainland. Ecuador, a country of 17 million, has more than 40,000 infections with 3,500 deaths. The Galapagos is the least affected of its provinces, with fewer than 80 infections among its 30,000 population.

- Research suspended -The 76 projects being carried out under the Center's auspices remain in limbo, and an international congress set to draw 200 scientists to the archipelago was canceled. The Charles Darwin Foundation, which has been operating on the islands for 60 years, had to shelve 20 research programs.

Around 30 of its scientists and volunteers who were carrying out field work "had to abandon their investigation sites," said Maria Jose Barragan, the foundation's CEO and science director. With them went "an important season of investigation into the reproductive cycle of birds" in the Galapagos, she said. The Galapagos National Park (PNG), a public body responsible for conservation of the archipelago, continues to operate.

- Adapting to less -The Charles Darwin Foundation fears, however, the long-term impact of the pandemic on future research. "I think the global picture for the conservation sector, regarding acquisition and availability of funds, will change becaus there will likely

be other interests" competing for funds, said Barragan. "We have to adapt, which is actually the principle of the theory of evolution: change and adapt," she said.

Galapagos Science Center head Carlos Mena says he does not believe "funding for science is decreasing, but yes, it will move to other sectors, such as economic rejuvenation or the study of diseases and viruses." As things stand, any freeze in research projects affects livelihoods on the archipelago. Mena says this will translate into almost a million dollars in lost revenue for 2020. "Science brings in revenue. It's not huge, not like tourism, but yes, it generates revenue."

In the months of lockdown, between March and May, the Galapagos -- which had more than 270,000 visitors last year -- lost $200 million in tourism revenue, according to the Provincial Chamber of Tourism. "The revenue is zero. There have been no tourists, therefore no admissions to the park, nor the economic revenue" they generate, said park director Andres Ordonez.

Mena believes tourism will come back stronger after the coronavirus, saying the work of researchers can "serve as a guide for better tourism" in the islands with their fragile ecosystems. "The Galapagos have always been considered as a laboratory for studying the evolution of species," he said. "We can also see them as a laboratory for building tourism or a better model of society than before the pandemic."

Rio de Janeiro, June 5, 2020 (AFP) - Brazil's death toll from the novel coronavirus has surged to become the third-highest in the world, surpassing Italy's, according to official figures released Thursday. The South American country of 210 million people reported a new record of 1,473 deaths in 24 hours, bringing its overall toll to 34,021, from 614,941 infections, the health ministry said. Italy has confirmed 33,689 deaths from 234,013 infections.

Johannesburg, June 4, 2020 (AFP) - South Africa said Thursday it had recorded 3,267 novel coronavirus cases in 24 hours, the biggest jump since the pandemic hit the country. Africa's biggest industrial power now has a total of 40,792 infections, the health ministry said. It saw a rise of 56 deaths for a total of 848 fatalities. More than half of the cases are in the Western Cape region where health services are under pressure.

South Africa is the sub-Saharan African country hardest hit by the pandemic. President Cyril Ramaphosa on March 27 ordered South Africans to observe a lockdown aimed at slowing the disease's spread. The move sharply limited people's freedom of movement while slowing an economy already in recession. But Ramaphosa has gradually eased the lockdown measures and allowed most of the economy to restart.

Masks to be compulsory on public transport in England (from the 15th June!)
Disease SARS United Kingdom
- 19 hours ago

Date: Thu, 4 Jun 2020 18:41:36 +0200 (METDST)

London, June 4, 2020 (AFP) - Masks will be compulsory on public transport in England from next week to prevent the spread of the coronavirus, transport minister Grant Shapps said Thursday. "As of 15th June, face coverings will be mandatory on public transport," he said at a daily briefing on the government's response to the coronavirus outbreak. The government had previously advised people to wear face coverings in enclosed spaces such as shops and public transport but stopped short of making them compulsory. They remain only a recommendation in Scotland, Wales and Northern Ireland, whose devolved administrations have responsibility for transport.

The announcement was made as part of plans to ease lockdown restrictions in England, as infection rates and the number of deaths from COVID-19 falls. A total of 39,904 people have died in the outbreak in Britain, according to the latest official figures, which is the second-highest toll in the world after the United States. "We need to ensure every precaution is taken on buses, trains, aircraft and on ferries," said Shapps, calling the use of face coverings a "condition of travel". Small children, the disabled and anyone with breathing difficulties would be exempt, he added. "We expect the vast majority won't need to be forced into this," he said, but warned that anyone refusing to do so could be prevented from travelling or even fined.

Cox's Bazar, Bangladesh, June 4, 2020 (AFP) - Rohingya refugees infected with coronavirus are fleeing quarantine in their Bangladesh camps because they fear being transferred to an isolated island in the Bay of Bengal, community leaders said Thursday. At least two infected refugees have gone missing since testing positive for the virus after the first COVID-19 death was reported Tuesday, they said.

About one million Rohingya -- most of whom fled a military crackdown in Myanmar in 2017 -- are packed into camps along the Bangladesh border, and the coronavirus has become the latest cause of misery. Aid agencies have long warned that the virus could cause chaos in the overcrowded camps, where social distancing is virtually impossible. So far only 29 infections have been detected, although 16,000 Rohingya are in quarantine zones within the camps.

It was not immediately clear how many tests have been conducted in the camps, but a senior health official said two people who proved positive had "fled the isolation hospital". He added that only 20 refugees agreed to be tested in the past two days because they believe those infected will be sent to Bhashan Char island in the Bay of Bengal. "It has created mass panic," Nurul Islam, a community leader, told AFP.

Bangladesh authorities have long wanted to establish a camp for 100,000 people on the isolated island, and have already sent 306 Rohingya there. "The Rohingya are petrified," the health official told AFP on condition of anonymity. "We have told them they won't be sent anywhere."

Some 500 isolation beds have been prepared in the camps, but most are empty because so few confirmed cases have been found, according to the official. The first Rohingya fatality from the coronavirus was announced only Tuesday, and health officials say they desperately need to increase testing to see how widespread the virus may be. But Khalilur Rahman Khan, the government administrator of one camp block, said doctors told him refugees were reluctant to participate.

Several Rohingya leaders said the transfer of the 306 refugees to Bhashan Char had sparked rumours that anyone with coronavirus would be sent to join them. "People are scared to go for virus tests," said Abu Zaman, a community leader. Mohammad Shafi, a camp neighbour of the refugee whose death was announced Tuesday, said people who had coronavirus symptoms such as fever and aches insisted they only had seasonal flu. "I tried to reassure them that this a curable disease and most people will recover, but many don't believe it," he said.

Santiago, June 3, 2020 (AFP) - Chile's government said Wednesday it was prolonging a three-week shutdown of the country's capital Santiago as the COVID-19 death toll reached a new daily record. Health officials said 87 people had died in the previous 24 hours, and nearly 5,000 new infections were recorded. The South American copper-exporting nation has now registered more than 113,000 infections and 1,275 deaths.

Health Minister Jaime Manalich confirmed the government was extending a three-week lockdown of the capital for another week. The city is home to seven million of the country's 18 million population and produces half its GDP. Manalich said the population's mobility had only been reduced by 30 percent, because of a large numbers of permits granted to those needed for essential activities. "There are many permits," the minister said, warning that "for the quarantine to be effective, mobility needs to be reduced by at least 50 percent."

The minister appealed to people to minimize time spent outside of their homes to help reduce infections, especially in the coming weeks when emergency health services are expected to be operating at maximum capacity. Already in Santiago, 97 percent of intensive care unit beds are occupied, while units in the rest of Chile report having reached 88 percent capacity.